Nearly a third of heart-related deaths due to pregnancy are potentially preventable

13th April 2017

More than a fifth of pregnancy-related deaths are due to heart problems, and almost three in ten of those are potentially preventable, says a new study from America.

The researchers looked at maternal deaths in Illinois from 2002 to 2011.  A total of 636 women died while pregnant or within a year of giving birth, producing an overall death rate of 37.1 per 100,000.  Of those 140 (22 per cent) were heart related.

The most common cause was cardiomyopathy (28 per cent), followed by stroke (23 per cent), high blood pressure (13 per cent) and heart rhythm problems (almost 11 per cent).  Fewer than one in ten had coronary artery disease.

Of the 39 women who died of cardiomyopathy, almost a third developed the condition during pregnancy (peripartum cardiomyopathy).

Women with cardiomyopathy who died were more likely to be younger.  The death rate in the under 20s was three times that of women aged 20 to 29 years.

Cardiomyopathy UK support nurse Robert Hall said: “This study illustrates the crucial need for awareness of the possibility of cardiomyopathy in pregnancy."

Dr Joan Briller from the Centre for Research on Women and Gender at the University of Illinois in Chicago, and colleagues looked at data collected by a network of maternity centres in Illinois which requires the reporting and review of all deaths to women within a year of pregnancy.

More than half of the total deaths from heart disease occurred in the first six weeks postpartum after birth, suggesting that women with high blood pressure, preeclampsia, or other heart risk factors or symptoms should receive more extensive care in this period, the researchers said in an article in Obstetrics & Gynaecology online earlier this month.

Of the heart-related deaths, 28.1% were deemed to be potentially preventable and pointed to care that was "amenable to change such as monitoring patients at risk for several weeks postpartum," the researchers reported.

Among potentially preventable deaths were those linked to incomplete, delayed, or inappropriate diagnoses or treatment, which was implicated in 48.7% of the heart related deaths. Other potentially preventable factors included failure to refer the patient to higher level care, patient noncompliance with treatment, obesity, and insufficient prenatal visits.

The researchers said: "Our data supports the need for more investigations into cardiovascular maternal mortality, organised communication between obstetricians and cardiologists, and the need for systems designed to better educate and communicate cardiovascular risk factors and warning signs to pregnant women and medical care providers."

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